FIELD OF THE INVENTION
Cystoscopy, particularly a method for removing concretions from the urinary tract, as well as placques and sclerotic clots within other human ducts. A principal difficulty in treatment within the urinary tract has been the inability of probing devices to reach the ureter or kidney. The suggested method and apparatus is of such diminutive diameter and flexibility to enable exploration and treatment in these critical areas.
______________________________________ DESCRIPTION OF THE PRIOR ART: ______________________________________ West German 847,950 West German 1,218,112 West German 1,284,561 West German 2,032,501 Great Britain 1,082,397 Russian 228,865 ROZE 3,413,976 BALAEV 3,543,757 EDINY 3,557,793 SCHMIDT-KLOIBER 3,785,382 KLOZ 3,792,701 POHLMAN 3,823,717 ANTONEVICH 3,830,240 ANTONEVICH 3,861,391 ______________________________________
Roze, (corresponding to Russian Pat. No. 228,865 and West German Pat. No. 1,218,112) employs a long medicine needle, 5 of apparent inflexibility, having an enlarged boss 6 at its end. The negative electrode 3 is in the form of an enlarged, truncated head and in turn is encircled by envelope 7 and lacquer coating 8. An inner tube 4 separates the positive electrode 5 from the head or negative electrode 3, except for the protuberant boss portion 6 of the negative electrode. Water is discharged between the two electrodes. It is submitted that this construction is of such a wide diameter and inflexibility so as to preclude exploration into the ureter and kidney.
German Pat. No. 847,950 employs sonic vibrations to crush the stone, wherein glycerin is used as a lubricant upon the concretion. German Pat. No. 1,284,561 employs a lithotrite having electrodes and a pulse generator to supply instantaneous pulsing discharges, thereby creating hydraulic shock waves in a washing liquid which has filled the bladder. It is noted that this particular technology is also correspondingly exampled in British Patent Specification No. 1,082,397, Russian Pat. No. 228,865 and U.S. Pat. No. 3,543,757; all in the name of Balaev. Balaev employs a system wherein electrical oscillations are converted to ultrasonic oscillations within a fluid medium.
German Pat. No. 2,032,501 teaches a vibrating longitudinal probe, together with a connection for an irrigation device. Similarly, Ediny U.S. Pat. No. 3,557,793 is an improved structure for alternately using an ultrasonic mechanical oscillation together with a controlled hydraulic impact which is produced by an electric discharge in a liquid medium surrounding the concretion.
Schmidt-Kloiber U.S. Pat. No. 3,785,382 is particular to a miniaturized mechanically oscillatory device to facilitate concretion breakdown. The patentee employs a long, thin and apparently inflexible lithotriptor guided inside a thin ureter catheter 12, allowing passage of a rinsing liquid in the annulus therebetween. This device is purely mechanical in that the electrodes 7 produce shock waves in a separate chamber maintained external to the patient's body. Similarly, Kloz U.S. Pat. No. 3,792,701 includes a transducer which is maintained externally to the patient's body, together with a vibrating probe attached to a cystoscope that includes a flushing probe.
Pohlman U.S. Pat. No. 3,823,717 teaches a particular structure for an ultrasonic probe, including a plurality of cutting teeth around a hollow tubular device to allow withdrawal of disintegrated particles. The Antonevich U.S. patents transmit ultrasonic forces transversely through a catheter. The disclosure in both patents is identical; the claims of U.S. Pat. No. 3,861,391 being particular to subject matter which was divided out of the earlier U.S. Pat. No. 3,830,240. These patents suggest the use of miniaturized components so that even stones lodged high in the ureter can be fractured without the necessity of open surgery; noted as the present practice. The inventive feature of these patents comprises a wave guide to particularize the motion of a slender wire as it mechanically impacts upon the concretion, without any disclosed use of hydraulic action.